# COMAR Title 10 — Maryland Department of Health

## Subtitle 27 — Board of Nursing

### Chapter 06 — Practice of Nurse Anesthetist

#### Regulation .06 Standards of Practice.

*COMAR 10.27.06.06*

A. A nurse anesthetist shall collaborate with an anesthesiologist, licensed physician, or dentist in the following manner:

  (1) An anesthesiologist, licensed physician, or dentist shall be physically available to the nurse anesthetist for consultation at all times during the administration of, and recovery from, anesthesia;

  (2) An anesthesiologist shall be available for consultation to the nurse anesthetist for other aspects of the practice of nurse anesthesia; and

  (3) If an anesthesiologist is not available, a licensed physician or dentist shall be available to provide this type of consultation.

B. The nurse anesthetist shall assure that a qualified anesthesia provider:

  (1) Performs a thorough and complete preanesthetic assessment;

  (2) Obtains informed consent for the planned anesthetic intervention from the patient or responsible other; and

  (3) Formulates a patient-specific plan for anesthesia care.

C. The nurse anesthetist as part of the standards of practice shall:

  (1) Implement and adjust the anesthesia care plan as needed to adapt to the patient's response to the anesthesia;

  (2) Monitor the patient's physiologic condition for untoward identifiable reactions and initiate appropriate corrective actions as required;

  (3) Enter prompt, complete, and accurate documentation of pertinent information on the patient's record;

  (4) Transfer responsibility for care of the patient to other qualified providers in a manner which assures continuity of care and patient safety;

  (5) Ensure that appropriate safety precautions are taken to minimize the risks of fire, explosion, electrical shock, and equipment malfunction;

  (6) Maintain appropriate infection control standards;

  (7) Evaluate anesthesia care to assure its quality;

  (8) Maintain continual competence in anesthesia practice;

  (9) Respect and maintain the basic rights of patients; and

  (10) Maintain medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.